Organization
SILOAM SPRINGS ADULT DEVELOPMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY G DEZURIK (ADMINISTRATOR)
(479) 524-5911
Entity
Organization
Contact information
Practice address
500 N COUNTRY CLUB RD, SILOAM SPRINGS, AR 72761-2920
(479) 524-5911
(479) 524-8075
Mailing address
PO BOX 585, SILOAM SPRINGS, AR 72761-0585
(479) 524-5911
(479) 524-8075
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251C00000X
AR
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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